Dissociative Fugue

What is dissociative fugue?

A dissociative fugue is a temporary state where a person has memory loss (amnesia) and ends up in an unexpected place. People with this symptom can't remember who they are or details about their past. Other names for this include a "fugue” or a “fugue state.”

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition lists fugue as a symptom of dissociative disorders. Before that, experts considered this symptom a separate condition.

What do fugue states look like and how long do they last?

The term “fugue” comes from the Latin word for fleeing or running away, which is why this symptom involves traveling or wandering. People who experience a fugue state usually can’t recognize gaps in their memory until they have evidence that they can’t remember something. People with this symptom can unintentionally travel to specific locations or wander. Often, they'll come out of the fugue state and feel confused because they don't remember how they got to where they are.

Fugue states can be as short as a few hours, or they can last for days or even months. When fugue states are shorter, it’s harder for others to see signs of them, as people with this might look like they’re late or absent from their usual comings and goings. When fugue states are longer, people can find themselves far away from their usual surroundings. They might try to take on a new identity and build a new life for themselves, which can last until their memories return.

What are the most common causes of dissociative fugue?

Dissociative fugues are most likely to happen because of two conditions, dissociative amnesia and dissociative identity disorder.

Dissociative amnesia

Dissociative amnesia is a type of memory loss where a person can’t access certain memories. This usually happens because of one or more severely traumatic events. Memory loss happens as a defense mechanism to protect a person from recalling disturbing or painful events. It can also happen because of ongoing strain, especially when a person faces sudden life changes, including ending relationships, financial or work troubles, or the loss of a loved one.

This condition happens in about 1.8% of the population and is much more common in people designated female at birth (it affects 1% of assigned males and 2.6% of assigned females). This condition happens commonly alongside dissociative identity disorder, but fugue isn’t common with this condition alone.

Dissociative identity disorder

Dissociative identity disorder (DID) was once known as "multiple personality disorder," but experts don't use this name anymore. The main symptom of this is having two or more personalities, causing a person to feel like they're possessed or no longer in control of their thoughts or actions. In some cases, the personalities have different voices, behaviors and memories.

People with this condition almost always have it because of severe trauma when they were children, such as emotional, physical or sexual abuse. The personalities usually develop as a defense mechanism to that trauma. DID affects about 1.5% of people, although there is controversy about how common this disorder is. Dissociative fugue is common with this disorder because different personalities don’t usually share memories.

How is dissociative fugue treated?

Dissociative fugue treatments depend on what causes it.

• Dissociative amnesia: When dissociative amnesia is the cause, treating this condition usually involves therapy to help you recover the missing memories. Memory recovery therapy can include techniques like hypnosis. Once your memories return (either partly or fully), you'll likely need therapy to help your process the original trauma.
• Dissociative identity disorder: When this condition is behind a dissociative fugue, the treatment usually involves therapy to help the personalities merge and rejoin the person who has them. It can also involve treatment and medication for other symptoms like depression or anxiety.

What can I do at home to treat this symptom?

Dissociative fugue is a problem you shouldn't try to self-diagnose or treat at home or on your own. That’s because this symptom is rare and happens with conditions that are hard to verify and diagnose, even for a trained, experienced mental health provider. A healthcare provider should evaluate any lapse or gap in your memory. That’s because memory loss is a common symptom of medical and brain conditions, some of which are dangerous or even life-threatening.

People who have a fugue often feel extremely upset or disturbed as their memories return, especially when they return suddenly. That can lead to overwhelming feelings of anxiety or depression. People with this symptom also need professional mental health care to help them with the effects of the trauma behind the condition that caused the fugue state(s) to happen.

More than 70% of people with dissociative identity disorder attempt suicide. Dissociative amnesia also has a high risk of self-harm or attempted suicide. Because the risk of suicide is so high, people with this need care from providers with the necessary education, training and qualifications.

How to get help for thoughts of self-harm or suicide

You should get emergency care if you have disturbing thoughts about harming yourself, including thoughts of suicide or harming others. If you have thoughts like this, you can call any of the following:

• Suicide and Crisis Lifeline (United States). To call this line, dial 988.
• Local crisis lines. Mental health organizations and centers in your area may offer resources and help through crisis lines.
• 911 (or your local emergency services number): You should call 911 (or the local emergency services number) if you feel like you’re in ++immediate++ danger of harming yourself. Operators and dispatchers for 911 lines can often help people in immediate danger because of a severe mental crisis and send first responders to assist. If you believe someone you know might attempt to harm themselves or attempt suicide, you should also call 911 or your local emergency services number.

How can dissociative fugue be prevented?

Dissociative fugue happens unpredictably, so it isn’t possible to prevent it.

When should dissociative fugue be treated by a doctor or healthcare provider?

Dissociative fugue is a symptom that happens with very complex disorders that are difficult to diagnose and treat. Because of that, a qualified provider should always treat this symptom and the related conditions.

In many cases, people with dissociative fugue will regain their memories on their own. However, because the memories usually involve severe trauma, people with this symptom almost always need professional mental health services to help them with the effects of the trauma.

A note from Cleveland Clinic

Dissociative fugue is an uncommon symptom of a rare, severe mental health condition, and people with this symptom often develop it because of traumatic events in their past. Because of that, a qualified mental health provider should be the one to diagnose this. People with this symptom often regain their memories, and mental health treatment can help them recover from the related conditions and their effects. If you believe you have this symptom or other signs of any form of amnesia, a qualified provider can help you get the care you need so you can focus on the things happening in your life that are important to you.